45D2168131 CLIA NUMBER - LEANONME PSYCHIATRY

Laboratory Demographics

  • CLIA Code: 45D2168131
  • Facility Name: LEANONME PSYCHIATRY
  • Facility Address: 318 W BELT LINE RD SUITE 304
    CEDAR HILL, TX
    ZIP 75104
  • Facility Phone: 972 972-4767
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ATEMNKENG F. DIBAKI
  • NPI Number: 1043776834
  • Taxonomy: 363LP0808X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 45D2168131
LAB Type Practitioner Other
Facility Name LEANONME PSYCHIATRY
Street 318 W BELT LINE RD SUITE 304
City CEDAR HILL
State TX
ZIP 75104
Phone 972 972-4767
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/21/2025
Certificate Expiration Date 6/20/2027
Facility Type Practitioner Other
Lab Director ATEMNKENG F. DIBAKI

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This page was last updated on: 9/29/2025